OBJECTIVE To investigate the incidence and trends of nosocomial infections of preterm infants in NICU and to explore their risk factors and strategies of infection control.METHODS A study was made among 1 026 hospitalized preterm infants from Jan 1992 to Dec 2004.RESULTS There were 316 times nosocomial infections in 266 preterm infants.Cumulative incidence rate for nosocomial infection was 25.9 neonates out of 100 admissions.The incidence density was 18.6 infections per 1000 patient days.The high risk factors for nosocomial infections included the parenteral nutrition,birth weight ≤1 500 g and mechanical ventilation(P

Objective To investigate the relationship of angiotensin converting enzyme (ACE I/D) gene I/D polymorphism with vitiligo.Methods PubMed,the Cochrane Library,China academic journal full-text database and VIP database and Wan fang database were searched according to the inclusion and exclusion criteria,and the quality of included studies was assessed.The data were quantitatively analyzed by Stata 12.0 software.Results Nine articles were included.Meta analysis results showed that the susceptibility of vitiligo difference was statistically significant in the total population of ACE I/D genotype (DD + II)vs.DI (OR=0.759,95％ CI:0.643 ～0.896,P=0.001),the (DD+DI) vs.II (OR=1.523,95％ CI:1.153 ～2.011,P =0.003).The genotype subgroup analysis showed the D vs.I (OR =1.381,95％ CI:1.054 ～1.810,P=0.019),DDvs.II (OR=1.830,95％ CI:1.110～3.017,P=0.018),(DD+ II) vs.DI (OR=0.814,95％ CI:0.667 ～0.994,P=0.043),and the (DD+ID) vs.II (OR=1.690,95％ CI:1.147 ～2.489,P =0.008) in Asian.The difference was statistically significantly related to vitiligo.Arab genotype (DD + II) vs.DI (OR =0.545,95％ CI:0.354 ～ 0.840,P =0.006) was associated with vitiligo occurrence.Begg's inspection publication bias analysis showed all genetic types did not exist any publication bias.Conclusions The ACE gene I/D polymorphism may be associated with vitiligo susceptibility.

Objective To study the clinicopathological characteristics and immunophenotype of solid pseudopapillary neoplasm (SPN) of the pancreas.Methods Retrospective analysis was performed for the clinical materials,pathological features and immunohistochemical phenotype characteristics of the 23 SPN cases.Results Ratio of male to female was 1:10;the average age was 32 years.10(43％) patients had no clinical symptoms,12 (52％) patients had abdominal pain,abdominal distention or diarrhea;1 patient had jaundice.Tumors were in the head of pancreas in 10(43％) cases,and were in the tail or body of pancreas in 13 cases.Grossly,tumors were solid-cystic or solid;the maximum diameter were from 1.3 cm to 17 cm,with the average of 5.9 cm;12 (52％) cases appeared encapsulated.Histopathologically,21 (91％) cases appeared to exhibit a fibrous capsule surrounding the tumors,and the fibrous capsule invasion were observed in all these cases;Pancreas tissues were involved in 8(35％) cases.Tumor cells arranged in sheets,nests and pseudopapillary patterns.Hemorrhage,necrosis and cystic degeneration were often seen.Tumor cells were positive for vimentin,β-catenin,CK,CD10,PR,CD56 and Syn.Tumor were mostly negative for CgA and Ki-67.23 cases were followed up for 2 to 44 months,and all were alive.Conclusion SPN is a low degree malignant tumor often seen in young women with various histological patterns and multiple immunophenotypes.Definite diagnosis of SPN can be made by combining clinicopathological characteristics with a panel of immunohistochemicat marks.SPN grows slowly,often responds to surgical resection and rarely recur.

Objective Through the analysis of misdiagnosis left renal vein entrapment syndrome,to improve the understanding and reduce the misdiagnosis of this disease.Methods 82 cases of left renal vein compression syn-drome were diagnosed with ultrasound,65 cases were misdiagnosed.Clinical data of these 65 patients were analyzed.Results In 82 cases,only 11 doctors from renal department of internal medicine,pediatrics,department of urology wrote application for it.Among the 65 misdiagnosed cases,30 cases of male,female 35 cases.The age ranged from 6 to 37 years old,the average age was 16.1 years.The misdiagnosis duration ranged from 2 months to 42 months,the median time was 7 months.43 cases of low back pain or backache,urinary tract irritation in 5 cases,60 cases of abnor-mal urinalysis:a simple urinary protein in 15 cases,21 cases of simple hematuria,proteinuria,hematuria 24 cases. 31 cases were misdiagnosed as chronic glomerulonephritis,occult nephritis(asymptomatic proteinuria and hematuria syndrome)in 11 cases,acute nephritis comprehensive sign in 9 cases,7 cases of lumbar muscle strain,urinary tract infection in 4 cases,1 case of urinary tract stones,pelvic inflammatory disease in 2 cases.In the 16 cases complicated with glomerular nephritis,were treated as the glomerular nephritis before (11 cases of chronic nephritis,5 cases of asymptomatic proteinuria and hematuria syndrome).12 cases of abnormal urine fluctuation,after a delay of 3 -16 months referral doctor was diagnosed with left renal vein entrapment syndrome.Conclusion The disease has no char-acteristic clinical manifestations,and most clinicians were short in understanding of the disease,so the misdiagnosis rate is high.The clinicians should improve the understanding of the disease,in order to reduce the misdiagnosis rate.

Objective:To assess the changing trends in Gleason score (GS)of Chinese prostate carci-noma (PCa)from January 1995 to December 2014.Methods:In the study,875 patients admitted to hospital from January 1995 to December 2004 (1995 -2004)and from January 2005 to December 2014 (2005 -2014)were divided into two groups.The mean levels and proportions of GS,primary and se-condary grades were studied.The patients were divided into four groups according to age: <60,60 -69,70 -79 and ≥80 years.Types of specimen included needle biopsy (NB),transurethral resection of the prostate (TURP)and radical prostatectomy (RP).Histological types were made up by acinar carci-noma and other types (including atrophic,pseudohyperplastic,foam,signet ring cell and ductal carcino-ma,and so on).The total prostate-specific antigen (tPSA)involved groups of <20.0 μg/L and ≥20.0 μg/L.We observed the mean levels and proportions of GS in age,types of specimen,histological types and total prostate-specific antigen in different periods,and used SPSS 17.0 software for statistical analysis.Results:Compared with 1995 -2004,the mean levels of GS,primary and secondary grades decreased 0.32 (P =0.003),0.19 (P =0.001)and 0.12 (P =0.016)in 2005 -2014,respectively. The proportions of ≤6 in GS increased 10.9% (P =0.003),and ≥8 decreased 14.0% (P <0.001). The difference of GS 7 was not statistically significant.In the primary grade,the ratio of grades≤3 in-creased 12.8% (P =0.001 ),and grade 4 decreased 7.4% (P =0.037),grade 5 decreased 5.5%(P =0.007).The ratio of secondary grades≤3 increased 7.6% (P =0.037).The difference of grades 4 and 5 was not statistically significant.Conclusion:GS in Chinese patients with PCa showed a down-ward trend,which is one of the notable features in the past 20 years in China.The types of specimen and age are important factors in GS,while the histological types and tPSA have less impact on the GS.

Objective To investigate the anti-IFN-α effects of the novel protein TSR'r' encodedby the 458 nt-1308 nt spliced variant of hepatitis B virus genome,and to determine its functional domaias.Methods the TSR'r' gene(originated from open reading frame of HBV DNA polymerase,T represents terminal protein region,S represents the Spacer region,R'represents the truncated reverse transcriptase region,and r'represents the truncated RNaseH region)of the 458 nt-1308 nt spliced variant of HBV genome and its deletants were amplified by PCR and were cloned into the pcDNA3.1/HisC vector.The recombinant vector was transfected into Huh7 hepatocytes individually by FuGENE6 transfection reagent,and the expression of the fusion protein was detected by Western blot.Huh7 hepatocytes were co-transfected with p6 16CAT and the recombinant vector harboring either TSR'r'or the related deletant,and treated with IFN-α 2a 48 h post transfection.After 24 h stimulating.the cells were lysed and the intracellular CAT value was calculated.All data were processed with One-way analysis of variance(ANOVA).Resuits Recombinant vectors harboring either the TSR'r'gene or related deletant were constructed successfully,and the fusion proteins were expressed well in Huh7 cells.When Huh7 hepatocytes were co-transfected with p6-16CAT and TSR'r' recombinant.the intracellular CAT values reduced gradually as paralleled with the increasing amount of TSR'r'recombinant.Furthermore,as compared with the empty vector,intracellular CAT values also decreased significantly when the Huh7 cells co-transfected with recombinant harboring TP plus Spacer regions,while any of the other deletants(harboring either TP or Spacer region or neither)showed no significant difference.Conclusion The novel protein encoded by the 458 nt-1308 nt spliced variant of hepatitis B virns genome suppressed the response of Huh7 hepatocytes to IFN-α.and the N-terminal TP plus Spacer region was the functional domain of the protein for anti-IFN-α effects.

Objective To elucidate the genome organization of small deletion mutants of hepatitis B virus(HBV).Methods Amplified the HBV genomes by polymerase chain reaction from the serum of the patients with chronic hepatitis B and cloned the small HBV DNA less than 1 kb,then sequenced and analyzed the gene organization of these small deletion mutants of HBV.Results Totally one hundred and twenty-four small deletion mutants of HBV genomes categorized to sixty-four types were obtained and classified into three groups according to the criteria of the characteristics of gene organization,for example,spliced variants,regular deletion mutants and the deletion mutants with an internal poly (dA).All of these isolated mutants shared some common features as the deletion in coding regions and regulatory elements,66% of the mutants retained the cis elements crucial for the viral replication and encapsidation,while 48% retained the X region.Conclusions Small deletion mutants of HBV are commonly detected in the serum from chronic hepatitis B patients,the characteristic structure of such mutants implies that they might be closely co-related with the pathogenicity of HBV.The exact mechanisms need further study yet.

Objective To explore the time of application of hemoperfusion (HP) for the treatment of acute serious organophosphorus pesticide (ASOPP). Methods One hundred and four patients with ASOPP were randomly divided into two groups, 46 patients accepted traditional treatment(control group), 58 patients were treated with traditional treatment and HP (HP group). The patients in HP group were again divided into three groups according the different time of treatment (time of beginning HP after poisoning), the 4-8 hours group (HP-1 group, 27 patients), the 9-16 hours group (HP-2 group, 19 patients), the 17-32 hours group (HP-3 group, 12 pafients).Tbe coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality and curing among groups were observed. Results The coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality of the HP group were less than those of the control group (P<0.05). Compared with HP-1 group, the eoma period, the dosage of atropine, the time of regaining the vitality of eholinesterase and the time of hospitalization of the HP-2 group and the HP-3 group were higher (P<0.05), but the difference of the rate of fatality and curing between the HP-1 group and the other HP groups was not statistically significant (P>0.05). The difference of all of the above indicators between HP-2 group and HP-3 group was not statistically significant (P>0.05). Conclusion Application of hemoperfusion among 4-32 hours after poisoning for the treatment of ASOPP can improve the efficacy of therapy, and the efficacy of application of hemoperfusion among 4-8 hours is the best.

Objective To study the clinical characteristics and imaging features of perinatal autosomal recessive polycystic kidney disease ( ARPKD) and a systematic review of the literature was performed to improve awareness of the disease. Methods A newborn with infantile ARPKD admitted to the neonatal department of our hospital was studied and her clinical data and imaging features retrospectively reviewed. CNKI, CBMdisc, MEDLINE and Embase databases were searched using autosomal recessive, perinatal and polycystic kidney as keywords. 9 case reports were retrieved from 2005 to 2015 and a total of 9 patients were analyzed. Results The gestational age of patients with infantile ARPKD was from 33 to 37 weeks. 6 of them were diagnosed using prenatal ultrasound and one patient was diagnosed using genetic sequencing. One of 10 infants had a family history, 4 patientsˊ mothers had abnormal pregnancy history (spontaneous abortion or miscarriage) and 7 (70. 0%) patients with respiratory failure needed mechanical ventilation. The ultrasound of all the patients showed enlarged and hyperechogenic kidneys. 9 patients died, and only one patient was alive after renal transplant. Conclusions The characteristics of perinatal APRKD are enlarged and polycystic kidneys, hepatic cysts and liver fibrosis. Infants with this disease have poor outcomes and high mortality rate. Respiratory failure and renal failure are the main causes of death in the neonatal period and early diagnosis and treatment are necessary.

Objective To discuss the safety of inhaled nitric oxide (iNO)for bronchopulmonary dysplasia (BPD).Methods We analysed 65newborns diagnosed as BPD from January 2012to December 2013in Maternal and Child Health Hospital of the Guangxi Zhuang Autonomous Region.They were divided into iNO group(n=35)and control group(n=30)according to whether administering iNO or not.The heart rate,blood pressure,oxygen supply time,assisted ventilation time,hospital stay,concentration of NO2 and methemoglobin,and the changes of coagulation function were observed dynamically before and after iNO treatment.Results There were significant differences in oxygen supply time[(37±9)d vs.(55±7)d], assisted ventilation time[(29±7)d vs.(35±9)d],hospital stay [(45±9)d vs.(54±7)d]between iNO group and control group(P﹤0.05).There were no obvious changes in heart rate,blood pressure and co-agulation function before and after iNO treatment(P﹥0.05).The incidences of the complications had no sig-nificant differences between the two groups (P﹥0.05).Conclusion Long-time iNO can shorten oxygen therapy time and assisted ventilation time,iNO therapy in BPD doesn′t found serious adverse effect to cardio-vascular function as well as coagulation function,and doesn′t increase the risk of intracranial hemorrhage and retinopathy of prematurity.